REE-010
Rev. 07/2020
IREC use only
License #:
__________________________
Approved:
__________________________
Supplemental Form for Active Military Service
Members and Spouses
575 E. Parkcenter Blvd., Suite 180
Boise, Idaho 83706
Offi ce: (208) 334-3285
irec.idaho.gov
Pursuant to Idaho Code 67-2602A and 67-2620(2)
Under Idaho statute, licensees, certifi ed real estate instructors, and individuals whose spouse is serving in the military are
exempt from the payment of licensing/certifi cation fees during the period that such licensees, certifi ed instructors, or the military
spouse are actively engaged in military services. Applications or certifi cations may be expedited.
TO BE ELIGIBLE TO USE this form, you or your spouse must be serving on active duty as a member of the United States
Armed Forces. “Active military duty” is defi ned as the period during which the person is actually engaged in the military services
of the United States or its auxiliary branches, or held as prisoners, plus six (6) months following discharge from such military
services.
*Please contact the Commission for further instruction if you or your spouse are on active military duty at the time of license/
certifi cation renewal.
1. PERSONAL INFORMATION
Applicant’s Full Legal Name : _____________________________________________________________________________
(must exactly match name on legal ID)
Social Security Number : ______________________________________ Date of Birth:
2. TYPE OF APPLICATION SUBMITTING (check one):
Salesperson Application Broker Application Cooperative Application Instructor Application
3. I certify that I am on active duty, or I am the spouse of an active duty service member in accordance to Idaho Code 67-2602A
and 67-2620(2).
_______________________________________
Applicant Signature
4. I certify that the answers appearing hereon are true and correct to the best of my knowledge and belief. I understand that
my application may be denied or my license inactivated, expired, terminated, suspended or revoked, and/or I may be subject
to disciplinary action, for the use of fraud, deception, misrepresentation, misstatement or omission or any unlawful means in
applying for or securing a license to act as a real estate salesperson, broker, or certifi ed instructor in the State of Idaho (Idaho
Code 54-2019, 54-2060(4) and 54-2025).
________________________________________________
Applicant Signature
NOTARY IS REQUIRED
State of )
) ss.
County of )
Signed (or attested) before me on ______________________________ by _______________________________________________.
Date Name of Individual (applicant)
___________________________________________________
Signature of Notary notary
seal
___________________________________________________
My Commission Expires
